title: Helicobacter pylori eradication in the prevention of gastric cancer: are more trials needed?
abstract: The incidence of gastric cancer has decreased in much of the world, but gastric cancer remains the second leading cause of cancer death globally, and the burden is growing in many countries in East Asia and Latin America. Chronic infection with Helicobacter pylori is the dominant cause of gastric cancer, and two recent randomized trials showed that H. pylori eradication significantly decreased gastric cancer risk. Population screening and treating individuals for H. pylori also appears to be cost-effective. Nevertheless, current clinical guidelines differ as to whether asymptomatic adults should be screened and treated for H. pylori, and no countries have yet implemented eradication programs. Some of this inaction may reflect lingering doubts about the effectiveness of H. pylori eradication in preventing gastric cancer, but there is also uncertainty about possible risks of mass antibiotic treatment and its impact on gut flora. Appropriately designed studies will help address these issues and hasten the implementation of population-wide prevention programs.
authors.affiliation: Prevention and Implementation Group, Early Detection and Prevention Section, International Agency for Research on Cancer, 150 Cours Albert-Thomas, 69372, Lyon Cedex 08, France, parkjy@fellows.iarc.fr.
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Park
authors.forename: David
authors.initials: D
authors.lastname: Forman
authors.forename: E Robert
authors.initials: ER
authors.lastname: Greenberg
authors.forename: Rolando
authors.initials: R
authors.lastname: Herrero
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008403:Mass Screening; D013274:Stomach Neoplasms / Q000382:microbiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents